AT least three women from rain-hit areas in Sindh recently died after contracting malaria, raising serious concerns about the efficacy of the treatment being given to patients suffering from this illness. As reported in this paper, experts are of the view that as many as 22,000 cases of malaria were reported in the province between August and October this year but there is a chance, given the poverty and lack of health facilities in many rural areas, that several more may have gone undetected. There is more than one factor in play here contributing to the alarming incidence of this mosquito-borne affliction. Poor sanitation and the breeding grounds it provides to mosquitoes is the obvious first cause, followed by inadequate fumigation. Then there are concerns that even those who have access to medical practitioners are not treated properly. Anti-malarial drugs are often prescribed in the absence of recommended tests and necessary investigative procedures. Experts say that such mono- or single-drug treatment without requisite back-up exploratory work may lead to a situation where the malaria parasite develops a resistance to the medicine in question and thus renders it ineffective.

Another related problem is the easy availability of drugs that should be dispensed only if prescribed by a doctor but can instead be bought over the counter. Self-medication is rampant and irrational use of drugs, particularly antibiotics, is also said to be a leading cause of germs mutating and developing a resistance to drugs that in an earlier time may have wiped them out. The issues at stake here don't end there. Advertisements for pharmaceutical products may be proscribed but producers have found a way around the ban by indicating that their ads are meant only for the attention of doctors. The health authorities must take urgent steps to address these concerns.